In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 9 ( 2022-9-16), p. e0274664-
Abstract:
Over one billion people live with disability worldwide, of whom 80% are in developing countries. Robust childhood disability data are limited, particularly as tools for identifying disability function poorly at young ages. Methods A subgroup of children enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial (a cluster-randomised, community-based, 2x2 factorial trial in two rural districts in Zimbabwe) had neurodevelopmental assessments at 2 years of age. We evaluated functional difficulty prevalence in HIV-exposed and HIV-unexposed children using the Washington Group Child Functioning Module (WGCFM), comparing absolute difference using chi-squared or Fisher’s exact tests. Concurrent validity with the Malawi Developmental Assessment Tool (MDAT) was assessed using logistic regression with cohort MDAT score quartiles, linear regression for unit-increase in raw scores and a Generalised Estimating Equation approach (to adjust for clusters) to compare MDAT scores of those with and without functional difficulty. A 3-step, cluster-adjusted multivariable regression model was then carried out to examine risk factors for functional difficulty. Findings Functional Difficulty prevalence was 4.2% (95%CI: 3.2%, 5.2%) in HIV-unexposed children (n = 1606) versus 6.1% (95%CI: 3.5%, 8.9%) in HIV-exposed children (n = 314) (absolute difference 1.9%, 95%CI: -0.93%, 4.69%; p = 0.14). Functional difficulty score correlated negatively with MDAT: for each unit increase in WGCFM score, children completed 2.6 (95%CI: 2.2, 3.1) fewer MDAT items (p = 0.001). Children from families with food insecurity and poorer housing were more at risk of functional difficulty. Interpretation Functional difficulty was identified in approximately 1-in-20 children in rural Zimbabwe, which is comparable to prevalence in previous studies. WGCFM showed concurrent validity with the MDAT, supporting its use in early childhood.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0274664
DOI:
10.1371/journal.pone.0274664.g001
DOI:
10.1371/journal.pone.0274664.t001
DOI:
10.1371/journal.pone.0274664.t002
DOI:
10.1371/journal.pone.0274664.t003
DOI:
10.1371/journal.pone.0274664.t004
DOI:
10.1371/journal.pone.0274664.t005
DOI:
10.1371/journal.pone.0274664.s001
DOI:
10.1371/journal.pone.0274664.s002
DOI:
10.1371/journal.pone.0274664.s003
DOI:
10.1371/journal.pone.0274664.s004
DOI:
10.1371/journal.pone.0274664.s005
DOI:
10.1371/journal.pone.0274664.s006
DOI:
10.1371/journal.pone.0274664.s007
DOI:
10.1371/journal.pone.0274664.s008
DOI:
10.1371/journal.pone.0274664.s009
DOI:
10.1371/journal.pone.0274664.r001
DOI:
10.1371/journal.pone.0274664.r002
DOI:
10.1371/journal.pone.0274664.r003
DOI:
10.1371/journal.pone.0274664.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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